Repealing Obamacare Puts Trans Lives in Danger

Pride Month is cause for celebration, but it's also a call to action.

This is an opinion piece by Diana Feliz Oliva, the Transgender Health Program Manager at St. John's Well Child and Family Center in Los Angeles.

This year, as the Trump administration stands poised to gut literal life-saving protections for LGBT individuals, typically celebratory pride events across the country are also reflecting the sense of urgency felt within our communities. As the Transgender Health Program Manager at St. John's Well Child and Family Center in Los Angeles, I can tell you: there is hope -- but it demands that you join the fight. You can start by joining the effort to save the Affordable Care Act.

The transgender community is one of the most discriminated against, marginalized and impoverished in Los Angeles. Transgender individuals are at risk for discrimination, hate crimes, violence, HIV, homelessness, substance abuse and suicide -- with many fighting for the right to simply exist. Until 2013, there was little communal effort or opportunity to improve the lives of trans people. That year, St. John's made history by becoming the first and only community health center in South Los Angeles to offer a Transgender Health Program (THP), which has grown from serving just nine patients to serving over 1,400 today. St. John's is one of the few trans-specific health centers in the United States supporting the basic human right to health for all individuals regardless of gender, providing low or no cost health care to individuals in need.

St. John's THP has evolved rapidly to address transgender patients' multifaceted needs. In just three years, St. John's has expanded clinic hours and the services we offer, including support groups, case management and referrals, victim advocacy and outreach, and assistance with legal name and gender marker changes. St. John's created the Trans*Empower Program, an economic and professional development program, and helped establish the Transgender Right To Health Committee, a health advisory board of patients that create and advocate for policy recommendations to eliminate health disparities and foster community well-being by providing the highest quality of care in South Los Angeles.

Prior to the ACA, many transgender people did not have access to health care to protect their lives.

The Transgender Health Program at St. John's believes that if we provide comprehensive and culturally competent health and social services for transgender people – services that address more than individual risk factors but also the social and structural determinants that drive those behaviors – we can vastly improve people's quality of life, and overall health and well-being. For example, as a multiracial community, we know that transgender people of color live at the intersection of multiple identities. We work to honor this by intentionally building our systems of care around those intersections on a case by case basis -- building a more innovative and healthy future for South Los Angeles.

The Affordable Care Act (ACA) has provided access to health care services and benefits for thousands of transgender people who often have nowhere else to go. The ACA requires that managed care health plans provide services to all transgender beneficiaries with the same level of health care benefits that are available to non-transgender beneficiaries. In addition, the ACA's regulations prohibit discrimination against transgender beneficiaries and require managed care health plans to treat beneficiaries consistent with their gender identity. Prior to the ACA, many transgender people did not have access to health care to protect their lives, to prevent significant illness or significant disability, or to alleviate severe pain, disease, or injury.

Because of the ACA, our transgender communities now have access to life-saving hormone medications and medical surgeries that are gender affirming. The ACA has saved thousands of transgender lives and has encouraged health centers to treat transgender people with dignity and respect. Because St. John's was able to serve this community through the ACA, we've been able to help lead the way in trans health research and serve as a model for other community health centers as they expand their services to include the trans community.

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The American Health Care Act would cut Medicaid by nearly $900 billion dollars, allow annual and lifetime caps on coverage, and let states waive protections against discrimination. This is why now, more than ever, we need to stand against discrimination and marginalization and defend the ACA at all costs. St. John's believes that access to health is a fundamental right -- not a privilege. Transgender rights are human rights.

Our actions or continued inaction will be the difference between a discriminatory, violent world or a world of freedom and equality.

I am no stranger to the need to fight for our rights, and the right to simply exist is first and foremost. With so many people seeking to erase LGBTQ people – and often through unimaginably brutal acts of violence – it is vitally important that those we lose are remembered, and that we continue to fight for justice.

Pride events are conversation starters, but in order to ensure the safety and respect of the LGBTQ community, we cannot rely on conversation alone. Our actions or continued inaction will be the difference between a discriminatory, violent world or a world of freedom and equality. All of us must stand up for the human rights of transgender and gender nonconforming people to confront this pattern of abuse and injustice. We must accept nothing less than a complete elimination of this pervasive inhumanity; we must work continuously together for justice.